When you're in the military or a family member of someone who is, getting prescriptions shouldn't be a nightmare. But with TRICARE’s formulary rules, copays, and pharmacy options, it’s easy to get confused-especially when it comes to generics. The good news? TRICARE covers generics aggressively, and for most people, they’re the cheapest, easiest way to get the meds you need. The bad news? Not every generic is covered, and the rules change depending on where you fill your prescription.
What Counts as a Generic Under TRICARE?
A generic drug isn’t just a cheaper version of a brand-name pill. It’s the exact same active ingredient, in the same dose, working the same way. The FDA requires generics to meet the same safety and effectiveness standards as brand-name drugs. TRICARE knows this. That’s why 92% of all prescriptions filled through TRICARE in 2025 were for generics. That’s higher than the national average. But here’s the catch: not every generic is automatically covered. TRICARE has a formulary-a list of approved drugs. If your doctor prescribes a generic that’s not on that list, you might have to wait. You’ll need a prior authorization, which means your provider has to prove it’s medically necessary. About 12% of generic prescriptions fall into this category. And while 78% of those requests get approved, that 72-hour wait can delay your treatment.How Much Do You Pay for Generics in 2026?
Your out-of-pocket cost for generics depends on where you get them. There are three main ways to fill a prescription under TRICARE:- Military pharmacies: $0 copay. Always. Whether you’re active duty, a retiree, or a family member, if you walk into a base pharmacy, your generic drug costs nothing. No exceptions. This is the best deal you’ll find anywhere.
- TRICARE Home Delivery: $14 for a 90-day supply, starting January 1, 2026. That’s up from $13 in 2025. It’s still cheaper than most civilian plans. You order online or by phone through Express Scripts, and it ships to your door.
- Network retail pharmacies: $16 for a 30-day supply. This rate hasn’t changed since 2025. You can use any pharmacy in the TRICARE network-CVS, Walgreens, Rite Aid, and others. Just make sure they’re in-network. If you go to a non-network pharmacy, you’ll pay more.
Why the Military Pharmacy Is the Best Option
Think about this: your civilian friend pays $30 for a 30-day supply of lisinopril. You walk into your base pharmacy and get the same pill for free. That’s not a perk-it’s a lifeline. For retirees on fixed incomes, active duty families on tight budgets, or anyone juggling multiple prescriptions, this $0 copay makes a huge difference. And it’s not just about the money. Military pharmacies are staffed by pharmacists who know TRICARE inside and out. They know which generics are on the formulary, which need prior authorization, and which ones you can’t get at all. They’ll flag issues before you even leave the counter. Compare that to a civilian pharmacy where the cashier might not know what TRICARE is, or worse, tells you your generic isn’t covered when it actually is. That’s a common complaint on military forums. One Reddit user in November 2025 said, “I spent 45 minutes arguing with a CVS pharmacist who didn’t know TRICARE’s $16 copay for generics.”What’s Not Covered? The Big Exceptions
TRICARE covers most generics-but not all. The biggest change in 2025 was the removal of weight loss medications from coverage for TRICARE For Life beneficiaries. As of August 31, 2025, drugs like semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda) are no longer covered for retirees and their spouses, even if they’re generic. That affects about 1.2 million people. The Defense Health Agency says this was due to budget rules under the 2024 National Defense Authorization Act. Critics, including healthcare policy analysts at the Congressional Budget Office, argue it creates a dangerous gap. Weight loss meds aren’t just for vanity-they’re used to manage diabetes, heart disease, and joint problems in older adults. Another blind spot: generic biologics. These are complex, injectable drugs that mimic biological processes. Even when generics (called biosimilars) are approved by the FDA, TRICARE requires higher levels of documentation to approve them. About 22% more prior authorizations are needed for these than for regular generics.
How to Check If Your Generic Is Covered
Don’t guess. Don’t rely on your doctor’s word alone. Use the TRICARE Formulary Search tool on Express Scripts’ site. Type in the exact drug name and strength. It will tell you:- Is it on the formulary?
- What tier is it? (Tier 1 = generic, best price)
- Do you need prior authorization?
- What’s the copay at each pharmacy type?
What to Do If Your Generic Isn’t Covered
If your drug isn’t on the formulary, your provider can request a prior authorization. This isn’t a long shot. As of 2024, 78% of these requests were approved. But it takes time. On average, 48 hours. Some need extra paperwork-lab results, diagnosis codes, proof you tried other meds first. If you’re in a rush and can’t wait, you can pay out of pocket and file for reimbursement. But that’s risky. TRICARE only reimburses if the drug is later approved. And you’ll need to submit the original receipt and a completed claim form. Another option: ask your doctor for a therapeutic alternative. Maybe there’s another generic on the formulary that works just as well. For example, if your generic blood pressure med isn’t covered, there are often 3-5 others that are.How TRICARE Compares to Other Plans
Medicare Part D? Average generic copay: $7-$10. VA benefits? Free for eligible veterans. TRICARE? $14 for 90 days via home delivery, $16 for 30 at retail. At first glance, TRICARE looks more expensive. But here’s what most people miss: TRICARE is the only plan that gives you $0 copays at military pharmacies. No other program offers that. Medicare doesn’t have military bases. VA doesn’t cover family members. TRICARE does. Also, TRICARE’s formulary is more restrictive than most commercial plans. While private insurers cover 98% of prescribed drugs upfront, TRICARE requires prior authorization for 15-20% of non-formulary generics. But that’s by design. The program saves $1.7 billion a year by pushing generics-and those savings help keep the whole system running.
Real Stories: What Beneficiaries Say
On Reddit, a Marine Corps retiree posted: “My generic cholesterol med costs $14 for 90 days through home delivery. My neighbor, who’s on Medicare, pays $30 for 30 days. I’m not complaining.” Another user, AirForceMom2023, wrote: “Got my lisinopril filled at base pharmacy today, saved $48 versus retail copay.” But not everyone’s happy. A 68-year-old retiree on the TRICARE For Life forum said: “I’ve been on a generic weight loss med for two years. Now I’m told I can’t get it anymore. My doctor says it’s the only thing keeping my diabetes in check. I’m stuck.” The 2025 TRICARE Beneficiary Survey showed 86% satisfaction with generic access-but 39% of retirees over 65 were frustrated by the weight loss drug cutoff.What’s Changing in 2026 and Beyond
The $13 to $14 increase for home delivery is the only big change for now. But bigger updates are coming:- Real-time benefit tools by Q3 2026: Your doctor will see your copay and coverage status right when they write the prescription. No more surprises.
- Step therapy expansion: By 2027, you might have to try one generic before moving to another, even if your doctor prefers the second one. This is already common for pain meds and mental health drugs.
- Pharmacogenomic testing by 2028: For certain high-risk drugs, TRICARE may test your DNA to see how you’ll respond before approving the prescription. It sounds high-tech, but it’s meant to reduce side effects and improve outcomes.
Bottom Line: Know Your Options
If you’re on TRICARE and need a generic drug:- Always check the TRICARE Formulary Search first.
- Use your military pharmacy if you can. $0 is better than $14.
- For chronic meds, use home delivery. 90-day supplies mean fewer trips and lower cost per pill.
- If your drug isn’t covered, ask your provider to request prior authorization.
- Don’t assume a generic is automatically covered-it’s not.
- Watch for changes. The formulary updates monthly.
Are all generic drugs covered by TRICARE?
No. TRICARE has a formulary-a list of approved drugs. While 92% of prescriptions are for generics, not every generic is on the list. If your drug isn’t covered, your provider can request prior authorization, which is approved about 78% of the time.
How much do I pay for generics in 2026?
At a military pharmacy: $0. Through TRICARE Home Delivery: $14 for a 90-day supply. At a network retail pharmacy: $16 for a 30-day supply. These rates are effective January 1, 2026.
Can I get my generic prescription filled at any pharmacy?
Only at TRICARE network pharmacies or military treatment facilities. If you use a non-network pharmacy, you’ll pay more-either 50% of the cost after your deductible or $48, whichever is greater. Always check the TRICARE website for a list of approved pharmacies.
Why was my weight loss generic denied by TRICARE?
As of August 31, 2025, TRICARE For Life beneficiaries (retirees and their spouses) are no longer covered for weight loss medications like semaglutide or liraglutide, even if they’re generic. This change was mandated by the 2024 National Defense Authorization Act. Active duty members and other TRICARE beneficiaries may still be eligible.
How do I find out if my drug is on the TRICARE formulary?
Use the TRICARE Formulary Search tool at www.esrx.com/tform. Enter the exact drug name and strength. The tool shows coverage status, tier, copay, and whether prior authorization is needed. It’s updated monthly and works on mobile devices.
Is TRICARE’s generic coverage better than Medicare or VA?
It depends. Medicare has lower copays ($7-$10) but doesn’t offer free pharmacy access. VA offers free medications but only to enrolled veterans, not family members. TRICARE offers the only $0 copay option at military pharmacies, which is unmatched by any other program. It’s less flexible than private insurance but more consistent for military families.
